Dexmedetomidine for sedation during electroencephalographic analysis in children with autism, pervasive developmental disorders, and seizure disorders.

STUDY OBJECTIVE

To assess the efficacy of dexmedetomidine in providing sedation during electroencephalographic (EEG) analysis in children with autism, seizure disorders, or pervasive developmental disorders (PDDs).

DESIGN

Retrospective chart review.

SETTING

University medical center.

MEASUREMENTS

The charts of 42 children, aged two to 11 years, who received dexmedetomidine for sedation during EEG analysis, were studied. Information collected included route of administration of dexmedetomidine (oral and/or intravenous [i.v.]), loading dose, and infusion rate. Heart rate, blood pressure, respiratory rate, and level of sedation were monitored every 5 minutes, and oxygen saturation was monitored continuously during the procedure. Interventions (administration of fluid or use of an anticholinergic agent) for hypotension or bradycardia were identified.

MAIN RESULTS

18 children received oral dexmedetomidine (range, 2.9-4.4 microg/kg) before placement of an i.v.. Forty patients received an i.v. loading dose of dexmedetomidine (2.1 +/- 0.8 microg/kg), which was given in increments of 0.5 to one microg/kg every three to 5 minutes until a sedation score of 3 to 4 was achieved. Effective sedation was eventually achieved in all patients. An i.v. infusion of dexmedetomidine was started (1.5 +/- 0.2 microg kg(-1) hr(-1)) in all patients. During performance of the EEG, adjustments in the infusion rate (increase or decrease) or additional bolus doses were necessary in 25 patients. No significant hemodynamic or respiratory effects were noted.

CONCLUSIONS

Dexmedetomidine provides effective sedation during EEG analysis in children with autism or PDD.